UNASSIGNED: We conducted a retrospective study of 48 patients with severe post-TB tracheobronchial stenosis who underwent surgical reconstruction between 2015 and 2018 in a TB-endemic region. Pre- and postoperative evaluations included Karnofsky performance status, modified Medical Research Council (mMRC) dyspnea scale, spirometry, chest computed tomography (CT) scan, and bronchoscopy. The primary outcome was intervention-requiring restenosis over the long term.
UNASSIGNED: The mean patient age was 30.6±9.9 years, with 91.7% females. Airway fibrosis was the predominant lesion (93.8%), affecting the bronchi (93.8%) and trachea (6.2%). All the patients underwent resection and anastomosis, and 56.2% required lobectomy. Postoperative complications occurred in 13 patients (27.1%), with prolonged air leaks being the most prevalent (12.5%). All complications resolved with conservative management. Significant improvements in performance status, dyspnea, and lung function were observed postoperatively and sustained for over 5 years. Within a median follow-up of 69 months, five cases of intervention-requiring restenosis occurred within the first year. The freedom from restenosis rate was 90% from 1 year onwards.
UNASSIGNED: Surgical reconstruction is safe and effective in treating severe post-TB tracheobronchial stenosis. Larger studies are required to validate these findings.
■我们对2015年至2018年在结核病流行地区接受手术重建的48例重度结核病后气管支气管狭窄患者进行了回顾性研究。术前和术后评估包括Karnofsky表现状态,改良医学研究理事会(mMRC)呼吸困难量表,肺活量测定,胸部计算机断层扫描(CT)扫描,和支气管镜检查。主要结果是长期需要干预的再狭窄。
■患者平均年龄为30.6±9.9岁,女性占91.7%。气道纤维化是主要病变(93.8%),影响支气管(93.8%)和气管(6.2%)。所有患者均行切除吻合术,56.2%需要肺叶切除术。术后并发症13例(27.1%),长期漏气是最普遍的(12.5%)。所有并发症均通过保守治疗解决。性能状态的显著改善,呼吸困难,术后观察肺功能,持续5年以上。在69个月的中位随访时间内,在第一年内发生了5例需要干预的再狭窄.从1年开始,再狭窄的发生率为90%。
■手术重建治疗肺结核后严重气管支气管狭窄是安全有效的。需要更大规模的研究来验证这些发现。